In vitro model of a semicircular canal: Design and validation of the model and its use for the study of canalithiasis

Obrist, Dominik; Hegemann, Stefan; Kronenberg, Dominique; Häuselmann, Oliver; Rösgen, Thomas

doi:10.1016/j.jbiomech.2009.11.027

Cited by 39 publications

(32 citation statements)

References 33 publications

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“…Nevertheless, evaluation of the nystagmic characteristics that are typical of HSC-BPPV has actually helped to support the theory of canalolithiasis, which is currently the most accepted etiopathogenetic theory justifying the various aspects of BPPV. In fact, the most accepted theory, supported by an vitro model of semicircular canals [Obrist et al, 2010], presumes the presence of otolithic debris of utricular origin that ends up as a free-floating mass in the lumen of the HSC or the PSC; the movement of this mass, caused by variations in the position of the head, produces a piston-like mechanism that triggers an endolymphatic flow from or towards the crista ampullaris. A diagnosis of HSC-BPPV differs from that of the PSC mainly in the nystagmic characteristics which, in the case of HSC-BPPV, show lower latency, last longer (from a few seconds to 1 min), have a purely horizontal trajectory and are bidirectional (geotropic or apogeotropic).…”

Section: Discussionmentioning

confidence: 99%

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Casani¹,

Nacci

Dallan³

et al. 2010

Audiol Neurotol

106

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The aim of this study is to compare the results obtained using 2 methods of treatment for horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV): the barbecue maneuver + forced prolonged position (FPP) versus the Gufoni maneuver. In a randomized prospective clinical trial, we recruited 147 patients affected by HSC-BPPV. The primary outcome was the absence of vertigo and nystagmus upon application of the supine roll test during the follow-up examination. A statistical evaluation was performed in order to assess whether any parameters (e.g. age, duration of nystagmus and symptoms) could influence in any way the results obtained with the 2 methods of treatment. One hundred and three of the 147 patients affected by HSC-BPPV had the geotropic form and 44 had the apogeotropic type. We were able to transform 29 cases of HSC-BPPV from apogeotropic to geotropic. Finally, we obtained a group of 112 patients who were randomized either to the barbecue + FPP procedure (54 patients) or to the Gufoni maneuver (58 patients). The most evident result is the higher percentage of success (statistically significant) with the Gufoni maneuver at the first session of treatment (86 vs. 61%). The final control showed that 44 out of 54 (81%) patients treated with the barbecue maneuver + FPP were symptom free compared to 54 out of 58 (93%) treated with the Gufoni maneuver. Both the barbecue maneuver + FPP and the Gufoni maneuver are valid methods for treating HSC-BPPV (geotropic forms). However, our results also indicate that the Gufoni maneuver has a significant advantage: the success rate shown at the follow-up, although without statistical significance, is undoubtedly higher (93 vs. 81%). This result, together with the fact that it is very easy to perform and that patient compliance is better, make the Gufoni maneuver the method of choice in HSC-BPPV treatment.

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Section: Discussionmentioning

confidence: 99%

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Casani¹,

Nacci

Dallan³

et al. 2010

Audiol Neurotol

106

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“…We fitted a polynomial through the average angular velocity (ω) in order to impose it on the computational fluid dynamics and finite element analysis models. In models T, H, O, and F, we used a simplified version of this velocity profile, in which the angular velocity first increased linearly to the maximal velocity of the polynomial (ω = 11.4 rad/s, "ramp up") over 0.111 s and subsequently Hallpike head manoeuvre, calculated with the polynomial described by Obrist et al (2010). The scale of the Y-axis differs between subplots 1 3 linearly decreased back to 0 rad/s in 0.111 s ("ramp down") (see Fig.…”

Section: Head Manoeuvrementioning

confidence: 99%

Asymmetric cupula displacement due to endolymph vortex in the human semicircular canal

Goyens

Pourquié

Poelma

et al. 2019

Biomech Model Mechanobiol

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“…The use of more accelerations and a smaller rotation angle did not decrease the incidence of this symptom. Three factors, including autonomic dysfunction, a longer BPPV duration before treatment, and anxiety, were reported to play a role in the occurrence of residual dizziness after BPPV treatments [7,21,38]. Fortunately, anxiolytics reduce residual dizziness after successful canalith repositioning maneuvers [39].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies have focused on the treatment outcomes following the canalith repositioning maneuvers or have made comparisons between different maneuvers [16,17,18], while only a few studies have designed models to explain the mechanics of BPPV or of the otolith debris movement [19,20,21]. Even fewer reports have focused on the correlation between the maneuvers and otolith debris movement [22].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

Tian

Sheng

Wang

et al. 2015

ORL

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Aims: This study aims to investigate the roles of the number of accelerations and rotation angle in the treatment of posterior semicircular canal benign paroxysmal positional vertigo (PC-BPPV). Methods: We enrolled 344 patients with unilateral PC-BPPV. Of these, 167 patients in the simple-step maneuver (SSM) group were accelerated twice and rotated 120° per step, whereas 177 patients in the multi-step maneuver (MSM) group were accelerated 4 times and rotated 60° per step. Dix-Hallpike (DH) tests were performed to categorize the treatment outcome as follows: ‘symptom free' if the result was negative, ‘symptom persistent' if the result remained positive after performing the maneuver 3 times or ‘canal conversion' if horizontal nystagmus was evoked. Results: Of the patients in the SSM and MSM groups, 78.4 and 91.5% became symptom free, respectively, while canal conversion occurred in 13.8 and 5.1%, respectively (p = 0.003, χ² test). The success rate after performing the maneuver once was 57.1% in the MSM and 32.3% in the SSM symptom-free patients (p = 0.001, χ² test). One month after the treatment, 22.0 and 9.6% of the SSM and MSM patients had symptom relapse, respectively (p = 0.007, χ² test). Conclusions: More accelerations and a smaller rotation angle improved the effectiveness and efficiency of the repositioning maneuvers and reduced canal conversion.

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In vitro model of a semicircular canal: Design and validation of the model and its use for the study of canalithiasis

Cited by 39 publications

References 33 publications

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo: Effectiveness of Two Different Methods of Treatment

Asymmetric cupula displacement due to endolymph vortex in the human semicircular canal

Comparative Study on the Roles of the Number of Accelerations and Rotation Angle in the Treatment Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo

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